Home Insurance refusing to pay out

lisyloo

I don't agree with tsx.
Your complaint needs to be formal. Until you have a letter of deadlock or 8 weeks have passed the ombudsman will simply refuse to take your case.
That's not the same as chatting with an operator on the phone and them not registering your complaint.
Do whatever you please but the ombudsman will not take your case until you meet their requirements.
I've won about 7 out of 8 complaints over the years and in each case I needed to go through a proper process. The first step is to find the process which is generally easy as it's on the paperwork and website.
Why delay things by not complying?

rs65

lisyloo wrote: »

I don't agree with tsx.
Your complaint needs to be formal.

No it doesn't. A complaint is an expression of dissatisfaction.

TSx

lisyloo wrote: »

I don't agree with tsx.
Your complaint needs to be formal. Until you have a letter of deadlock or 8 weeks have passed the ombudsman will simply refuse to take your case.
That's not the same as chatting with an operator on the phone and them not registering your complaint.
Do whatever you please but the ombudsman will not take your case until you meet their requirements.
I've won about 7 out of 8 complaints over the years and in each case I needed to go through a proper process. The first step is to find the process which is generally easy as it's on the paperwork and website.
Why delay things by not complying?

I agree in many cases it's easier to just mention you're making a formal complaint - however it is useful to know the rules (and this sometimes adds weight to a complaint if you can show they have not followed the correct FCA rules in handling the complaint)

However it doesn't change the fact a complaint is defined by the FCA as

Any expression of dissatisfaction about a financial service by a customer – whether in writing or spoken – is considered to be a complaint.

Generally, complaints must allege that the customer has suffered (or may suffer):

an financial loss
material distress or
material inconvenience

source

I've worked for insurers in the past who don't log complaints unless it is clear a complaint is being made and also one's who will log every single expression of dissatisfaction (in many cases without the consumer being aware).

It doesn't change the fact that if you call up and say "I'm not happy that you're not covering my claim" then that is when the timer starts - they have 8 weeks from that point (and that is how the ombudsman would view it) to resolve the complaint and issue a final decision (if they don't resolve within 24 hours).

The rules will be changing in the summer but are largely the same.

dunstonh

Whilst a complaint is an expression of dissatisfaction, the person on the phone may well view you as venting frustration and there is a tipping point where the person may see if they can resolve it on the phone with you then or whether it should be handled as a formal complaint. As TSx says, different people will have different views on what tips the scale from venting, discussion or complaint. So, stating you want to make a formal complaint avoids any confusion.

Everyone is right in what they are saying. Just to varying degrees of interpretation and general common sense.

lisyloo

rs65 wrote: »

No it doesn't. A complaint is an expression of dissatisfaction.

What I am saying is that if you just have a casual chat with a call operator on the phone they might think you are just chatting with them and not register it as an expression of dissatisfaction and take no action.
Why take that risk? Why not make it clear that you require action and resolution.

The semantics are not important. The action and recognition by the insurer is what we need to acheive not them ignoring it as small talk.
The easiest way to make it clear is by letter. Personally I prefer email as receipt/read receipts mean you can prove it was delivered and read.
We know that instructions over the phone are not always provable because that's the entire cause of the issue.

rs65

lisyloo wrote: »

Why take that risk?

What risk is there. Everyone who works in insurance/finance has had training in this. It's the insurer who is at risk of not handling complaints properly.


If you make a complaint over the phone, even in a casual conversation, you would expect a procedure to be followed.

dblue75

***Update*** email today from insurer asking for the details of the company who did the work in order to call them and confirm works indeed had been conducted and paid for.

2 hours later I received another email. Payment in full passed for processing will receive in my account within 10 days.

Thank you all for your advice.